title: Anaesthetic management for endovascular treatment of unruptured intracranial aneurysms.
abstract: BACKGROUND
  Endovascular techniques for treatment of intracranial aneurysms are increasingly commonly applied. In general, the procedures are short, require general anaesthesia and complete immobilisation of patients. The aim of the present study was to assess the usefulness of general anaesthesia with propofol and laryngeal mask airway for endovascular management of intracranial aneurysms based on analysis of haemodynamic stability.
  
  
  METHODS
  The study encompassed 26 patients undergoing endovascular treatment of intracranial aneurysms. The mean arterial pressure (MAP), heart rate (HR), bispectral index (BIS), end-tidal CO₂(E(T)CO₂) and haemoglobin saturation with oxygen (SpO₂ ) were determined at eight measurement points: T₁ - before anaesthesia induction, T₂ - after induction, T₃ - after LMA insertion, T₄ - during arteriography, T₅ - during "coiling" , T₆ - at completion of propofol infusion, T₇ - before LMA removal, T₈ - after LMA removal.
  
  
  RESULTS
  MAP and HR were found significantly reduced between T₂ and T₁ . To maintain BIS within the range of 40-60, the following propofol infusion rates (in mg kg b.w.⁻¹ h⁻¹ ) were required: T₂ - 4.5 ± 0.3; T₃ - 4.6 ± 0.7; T₄ - 4.5 ± 0.8 and T₅ - 4.4 ± 0.6. E T CO₂ and SpO₂ were not demonstrated to be changed. The mean duration of anaesthesia and of recovery was 64.3 ± 21.8 and 8.9 ± 4.8 min, respectively.
  
  
  CONCLUSIONS
  General anaesthesia with propofol and LMA ensures suitable conditions for endovascular treatment of intracranial aneurysms.
authors.affiliation: Department of Neuroanaesthesiology, Medical University of Gdańsk, Poland. zkarw@gumed.edu.pl.
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Karwacki
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Witkowska
authors.forename: Seweryn
authors.initials: S
authors.lastname: Niewiadomski
authors.forename: Andrzej
authors.initials: A
authors.lastname: Wiatr
authors.forename: Paweł
authors.initials: P
authors.lastname: Bukowski
authors.forename: Jolanta
authors.initials: J
authors.lastname: Wierzchowska
authors.forename: Adam
authors.initials: A
authors.lastname: Zapaśnik
mesh_terms: D000762:Anesthesia Recovery Period; D000768:Anesthesia, General / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D062186:Arterial Pressure / Q000502:physiology; D002245:Carbon Dioxide / Q000378:metabolism; D056805:Consciousness Monitors; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D017214:Laryngeal Masks; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism; D015742:Propofol / Q000008:administration & dosage; D013997:Time Factors
chemical_list: D018686:Anesthetics, Intravenous; D006454:Hemoglobins; D002245:Carbon Dioxide; D010100:Oxygen; D015742:Propofol